Diet better than statins in kids' cholesterol control

The prescribing of statins for eight years-olds is tantamount to
saying that food and diet have failed, and that children are
incapable of changing their eating habits and lifestyle.

Last week, the American Academy of Pediatrics (AAP) announced
recommendations to prescribe cholesterol-lowering statin drugs to
obese children as young as eight.
But prescribing statins to children is the complete opposite of
what should​ be happening. We cannot sensibly expect to
maintain eight year-olds on statins until the end of their days.
This may seem like a winning situation for pharmaceutical
companies, but the financial, health and ethical implications for
the public don't bear thinking about.
As the old saying goes, it's better to have a fence at the top of a
cliff than an ambulance at the bottom.
The AAP has rightly been roundly criticised for its statement and
now is the time for the food and nutrition industries to speak out
and emphasise the value of dietary approaches.
There can be no argument over the danger of living with high
cholesterol levels, or hypercholesterolaemia to give it its
scientific term. The condition has a long association with many
diseases, particularly cardiovascular disease (CVD), which is the
number one killer on both sides of the Atlantic.
Statins have a significant role to play in the fight against
hypercholesterolaemia. Indeed, children even younger than eight are
currently prescribed statins but only if they suffer from
conditions such as familial hypercholesterolaemia (FH). It is not
wise to make widespread recommendations for a generation of eight
year-olds.
When I first read that AAP was taking such a stance a number of
questions jumped to mind. First off, how irresponsible and
potentially dangerous is it to prescribe eight year-olds statin
drugs? Secondly, have any studies ever been performed to show that
this course of action is not only successful but also safe?
AAP panel member Dr Nicolas Stettler from the Children's Hospital
of Philadelphia said: "We know that in adults, decreasing
cholesterol and giving some of those drugs decreases risk of heart
disease or death. So there's really no reason to think that would
be any different in children."
That is not a statement borne of science. One doubts that Dr
Stettler will be accountable in 40 years time if something
different emerges.
The lifestyles of these children have got them into this state;
their lifestyle must get them out of it.
And that means changing their diet.
There is a wealth of dietary approaches to lower cholesterol - we
all know about plant sterols, clinically proven to reduce total
cholesterol levels by eight to 17 per cent if consumed at a daily
amount of 1.5 to 3 grams. Moreover, post-launch monitoring studies
report that these do work in real populations.
On top of this, there are a number of other avenues available:
Oatmeal and beta-glucan from oats have numerous studies backing up
their efficacy. Then there is soy, omega-3 rich oils, and even
garlic.
In addition, a day after the AAP released its statement, we
reported on a study from the University of Pennsylvania Health
System that found fish oils, red yeast rice and other lifestyle
changes may reduce cholesterol levels by the same amount as a daily
statin pill - a whopping 42.4 per cent drop in LDL-cholesterol
levels was reported.
No-one in their right mind can say that dietary avenues do not
exist.
And no-one can say that these will not work with eight
year-olds.
Blaming the food industry for the growing obesity epidemic and
looking to the pharmaceutical industry to rescue us from impending
doom is short-sighted. It also highlights a disturbing
misunderstanding of the complexity of obesity.
Even if people don't have the same reaction as me, let me explain
the economics of it: It's cheaper to build fences than it is to buy
ambulances.
Stephen Daniells is the science editor for NutraIngredients.com
and FoodNavigator.com. He has a PhD in chemistry from Queen's
University Belfast and has worked in research in the Netherlands
and France. ​​If you would like to
comment on this article, please email
stephen.daniells'at'decisionnews.com​​